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Chronic fatigue in primary care attenders

Published online by Cambridge University Press:  09 July 2009

Elizabeth McDonald ,
Anthony S. David ,
Anthony J. Pelosi  and
Anthony H. Mann
Elizabeth McDonald
Affiliation:
Departments of Epidemiology and General Practice and Psychological Medicine, Institute of Psychiatry, London
Anthony S. David*
Affiliation:
Departments of Epidemiology and General Practice and Psychological Medicine, Institute of Psychiatry, London
Anthony J. Pelosi
Affiliation:
Departments of Epidemiology and General Practice and Psychological Medicine, Institute of Psychiatry, London
Anthony H. Mann
Affiliation:
Departments of Epidemiology and General Practice and Psychological Medicine, Institute of Psychiatry, London
*
1Address for correspondence: Dr Anthony S. David, Department of Psychological Medicine, King's College Hospital, Denmark Hill, London SE5 9RS.
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Synopsis

From 686 patients attending primary care physicians, 77 were identified by a screening procedure as having chronic fatigue. Of these, 65 were given a comprehensive psychological, social and physical evaluation. Seventeen cases (26%) met criteria for the chronic fatigue syndrome. Forty-seven (72%) received an ICD-9 diagnosis of whom 23 had neurotic depression, with a further 5 meeting criteria for neurasthenia. Forty-nine were ‘cases’ as defined by the revised Clinical Interview Schedule (CIS-R), and 42 if the fatigue item was excluded. Psychiatric morbidity was more related to levels of social stresses than was severity of fatigue. The main difference between these subjects and those examined in hospital settings is that the former are less liable to attribute their symptoms to wholly physical causes, including viruses, as opposed to social or psychological factors. Identification and management of persistent fatigue in primary care may prevent the secondary disabilities seen in patients with chronic fatigue syndromes.

Type
Original Articles
Information
Psychological Medicine , Volume 23 , Issue 4 , November 1993 , pp. 987 - 998
Copyright
Copyright © Cambridge University Press 1993

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